Practice Management News and Views from around the World – April 2017

Dogs in Cars – California

Richard Goebel and John Sheridan receive prestigious veterinary awards in Las Vegas

VetPartners.org - a national nonprofit association of veterinary business specialists dedicated to serving the veterinary profession, named its 2017-2018 Board of Directors at their Annual Meeting March 3-5, 2017, in Las Vegas, Nevada.

Also at the meeting, the organization inducted 20 new members and honored two members with distinguished awards.

“VetPartners is fortunate to have a group of deeply committed members and board members and we are very pleased with the breadth of experience and perspective they bring,” said Bruce Truman, Board President.

Former Board President, Tracy Dowdy added, “with a solid Board in place, VetPartners is poised to continue it’s core values and mission of providing a community of networking, collaboration, and integrity to serve members for the good of the profession.”

VetPartners presented two awards at the annual meeting; the Distinguished Life Member award to Richard Goebel, DVM, and the Pioneer Professional Member award to John P. Sheridan, BVetMed, DMS, CVPM, MRCVS.

Dr. Goebel is Special Assistant to the Dean at Purdue University School of Veterinary Medicine where his responsibilities include practice management education for veterinary students and technician students, and leadership in special clinical and development projects. Dr. Goebel serves as a faculty member for the Finance Module of the Veterinary Management Institute, a certificate series of the AAHA & Krannert Executive Education Programs, Krannert School of Management, Purdue University.,

John Sheridan receiving award from Peter Weinstein DVM, a Past President of VetPartners

In 1985, after a 25 year career as a small animal clinician during which he established a small group of franchised veterinary practices, Dr. Sheridan was appointed MD of Anicare Group Services (Veterinary) Ltd. Later, he jointly founded Veterinary Practice Initiatives Ltd, the first veterinary corporate consolidator in the UK, until he retired in 2003 and remained on the Board until the company was acquired by CVS in 2005.

Richard Goebel

After a 25 year career as a small animal clinician during which he established a small group of franchised veterinary practices, Dr. Sheridan was appointed MD of Anicare Group Services (Veterinary) Ltd. Later, he jointly founded Veterinary Practice Initiatives Ltd, the first veterinary corporate consolidator in the UK, until he retired in 2003 and remained on the Board until the company was acquired by CVS in 2005.

Dr. Sheridan now offers part-time management consultancy to the veterinary profession and publishes Veterinary Business, an online practice management resource for the international veterinary community. He also presents and publishes the online Veterinary Business Video Show with a new episode every two weeks.

Established in 2002, VetPartners™ has 240 members ranging in over 20 professional categories of expertise pertaining to veterinary practice management. VetPartners™ members are committed to providing services to the profession to help practices maximize their potential. Many members are available for speaking engagements on industry-specific themes and topics. Members believe in exemplary character and agree to abide by a Code of Ethics.

You can click here to visit the VetPartners.org website

So you think you can merge

From an article by Karen Felsted published in Veterinary Economics

Merging one veterinary practice with another is one of those ideas that sounds swell in theory but is really hard to do. Nevertheless, if you can identify the right partner, it’s an idea worth considering.

What counts as a “merger”?

In this article, I’m defining a merger as two or more practices combining into one legal entity; not one practice “merging” with a large corporate conglomerate—that last situation is more accurately described as an “acquisition” by the larger entity.

There are many merger models. Often, two veterinary hospitals combine and practice together under one roof. Other times, practices combine into a single legal entity but continue to operate out of their original locations. Owners of the individual practices can share equal ownership of the combined entity, or they can have varying percentages of ownership.

The ups and downs of merging

Mergers can create economies of scale with regards to facilities, equipment, inventory and staffing. They can expand services available at different locations and improve medical and surgical expertise—more heads are better than one. Merged practices can also benefit from shared management responsibilities and improved practice revenue and profits. They can even improve doctor and team quality of life (somebody to cover the shifts!) and provide a potential exit strategy.

Of course, there are downsides.

One of the hardest aspects of a merger for many veterinarians is the loss of autonomy. Instead of being the sole decider on every decision, each owning doctor has to function as part of a partnership. Furthermore, putting a merger together takes time and money and often involves difficult logistical decisions. Will one veterinarian need to give up his or her facility? Will staff be let go? And if the owners end up being unable to get along, breaking the merger can be painful, time-consuming and costly.

Merger basics

The first step in pursuing a merger is to identify the right practice partner, which is no small task. Finding a suitable business partner can be as difficult as finding a life partner.

The merged entity needs owners who can respect each other’s differing views and choices and be OK with the fact that they won’t always get their way. It’s also critical that merging practices have a shared vision for the future. For example, if one partner wants the merger to jumpstart a veterinary empire and the other is just looking for an easier way to cruise into retirement, the partnership may not work.

Merger checklist

Even when future visions are aligned, there will always be day-to-day differences of opinion about how to do things. Like spouses or life partners, business partners need a way to resolve differences respectfully and to find solutions everyone can live with when they don’t agree.

If the practices plan to operate under the same roof—or clients will be routinely visiting multiple locations—the practices also need to share a similar medical philosophy and offer comparable fees and client service experiences. A client who has been totally happy with less-than-gold-standard care (and the costs that go with it) won’t fit in at a newly merged practice that emphasizes much more comprehensive (and expensive) care. And clients accustomed to friendly, slow-paced visits with doctors and staff they’ve known forever won’t be happy in a fast-paced environment with a bunch of people they don’t know.

My parting advice? Get yourself professional guidance as you work through the process. A good consultant can help you identify the key issues that need to be addressed both in identifying a good partner and dealing with the nuts and bolts. A veterinary CPA can help you with valuation and tax issues, and an attorney can structure the transaction properly and make sure you have an orderly way to break up if that (unfortunately) happens.

You can click here to visit the DVM360.com website 

You can click here to visit Karen Felsted's website 

Do You Pass the Stress Test?

From an article by Management Today Staff

These are, it seems, increasingly stressful times. According to a 2014 report by the chief medical officer for England (their most recent report), the number of sick days lost to stress, depression and anxiety in the country increased by a whopping 24% between 2009 and 2013.

If that’s giving you palpitations, the bad news is things haven’t been getting better. The latest estimates from the Health and Safety Executive show that 440,000 workers in 2014/15 suffered from stress caused or made worse by their current or past work, while each person who was suffering from work-related stress took an estimated 23 days off that year on average, costing the economy billions of pounds.

Stress can come from anywhere, but common causes are unrealistic demands and time pressure, and a sense of powerlessness over your own circumstances – all of which is only likely to get worse given ongoing economic cuts, the rise of temporary contracts and the relentless march of technology, not to mention the potential fallout of Brexit, which even our political leaders seem unable to predict.

Add in the glow of the smartphone screen, making it ever harder to escape from work, and ever easier to get consumed by events you can’t control, and you can see why, for many, the balloon can easily burst. ‘The phone buzzes all the time, from first thing in the morning to last thing at night,’ says Dil Sidhu, chief external officer at Alliance Manchester Business School. ‘It’s almost like the brain has to be buzzing all the time. People don’t recognise that doing nothing is actually helping your brain put things in context.’

Stress can have a huge impact on people’s health and performance. It affects behaviour, physical health, decision-making, self-worth and personal relationships. An estimated 9.9 million working days in 2014/15 were lost in total due to work-related stress, depression or anxiety.

If your employees are at risk of suffering stress or mental health issues, then you need to do something about it. You’ll not only be helping people, but you’ll also create a more positive environment for your workforce – everyone will be happier, more productive and in a position to bring fresh ideas to the organisation. Here’s what you can do:

1. Be understanding

There are plenty of ways to offer support to those suffering stress. Yorkshire Water runs two-day courses to train employees as mental health first-aiders; law firm Hogan Lovells offers an in-house councillor who offers appointments directly, without having to involve HR or line managers; PwC recently appointed a mental health leader; and EY has introduced an informal buddy system for people to share their experiences of mental health issues with those who’ve been there themselves.

2. Change habits

A culture of presenteeism doesn’t give people the necessary time to recharge. ‘You get to the stage where people have two jackets,’ says Sidhu. ‘So if they leave one on the chair at work it looks like they’re still there.’ It doesn’t have to be like that: just 2% of Danish employees and 1% of Swedish employees work very long hours, compared to the OECD average of 13%. And it’s not just about being physically in the office. Amazon hit the headlines in 2015 for allegedly sending staff work emails after midnight and following them up with text messages asking them why they hadn't answered. Just thinking about that is stressful.

3. Listen to your employees

Make sure you’re doing things for them, not to them. When Lloyd’s of London banned daytime drinking this year, it may have seemed like a sensible way to boost health. But its employees suddenly found themselves having to go against a centuries-old tradition, and turn down pints in important lunch meetings or risk being dismissed. What became a source of stress could have been avoided if the company had asked employees before implementing it.

4. Empower line managers to make a difference

If someone’s immediate boss is putting in 12-hour days, what message does that send out to others in the team who are ambitious but may also wish to go to yoga after work to sort out their bad back? That line manager could instead demonstrate that the business won’t fall apart if you leave early on Fridays to actually see your kids.

5. Encourage better sleeping

Sleep helps us consolidate information, deal with the events of the day, and recharge our batteries. But it’s a cycle: lack of sleep causes stress; and the more stressed you are, the more you may struggle to sleep. People need their seven to nine hours at night, while napping can reduce anxiety and depression by minimising levels of cortisone, a hormone that elevates your blood sugar. Uber, Google and even PwC are among the companies to have installed nap pods for employees, with the latter also introducing in-house programmes to teach staff good sleep practices, acknowledging that it’s not only good for staff, it also provides a commercial edge by boosting their performance

You can click here to visit the Management Today website  

What’s the problem with Millenials?

From an article by Mike Pownall and published on his VeterinaryBusiness Matters.com website

When I tell other veterinarians that 98% of the people I work with are female, and 75% of our employees are Millennials I am faced with shaking heads and disbelief. “How can you work with all those women and young people” they ask. Surprisingly, many of those asking about working with “all those women” are female vets. In turn, I end up shaking my head as I tell them it isn’t a big deal, and that age or gender has rarely been an issue in our organization. When they ask why I tell them that there are 3 key factors we consider at all times to ensure workplace harmony: culture, expectations, and training

Before I discuss these 3 areas it is important to understand the mindsight we developed when my wife and business partner, Dr. Melissa McKee, and I first started our business. We knew that we were going to need other vets and support staff as we grew

Looking at the source of future employees we knew that the supply of new vets and support staff was going to be predominantly female. We also knew that these employees were likely going to be in their twenties. With this in mind we had to create a workplace culture that would be welcoming to this younger generation, rather than force them to accept what we thought was appropriate. For example, knowing that quality of life is important to the newer vets we planned to grow in size so we had enough vets to share on call so we weren’t working 24/7. At the same time, we put ourselves in the shoes of younger employees who may never had a structured job before so we knew we had to offer training and mentorship to help these new employees understand the expectations of a job.

This brings us to where we are now and how we are able to have harmonious workforce that is predominantly female and young.

The culture of a business is the DNA of the business. It is how people interact with each other and their clients. It reflects the values and purpose of a business. It is either something that develops on its own if left unchecked, or it can be nurtured and kept in a desired state if managed correctly.

When we hire new employees it is critical that they fit into our culture. They have to share our values and outlook. This doesn’t mean that we look for clones, rather we want unique individuals that fit into our group. When everyone shares similar values it is easier for everyone to get along regardless of their gender, age, background, political views, etc.

“hire for the smile and train the skills”

We hire for the smile and train the skills. We don’t care how qualified a veterinary prospect is, or how capable someone is working in the office if they cannot get along with their co-workers and engage well with our clients they won’t work well with us. Skills can be trained, but attitude is set. We hire for shared values and how they fit into our culture, and then expect to train the skills that may be lacking.

When we hire people we are very clear with our expectations of appropriate workplace behavior. In the past few years we have noticed that we are the first job for many of our new hires. This means they are not aware of how a workplace works. This can range from little things like showing up on time to critical areas like how co-workers treat each other in the workplace. We are very clear on workplace expectations, and to ensure that these expectations are met we maintain a system of training and coaching to help our new hires succeed in their job. When someone does not meet our expectations for workplace behavior we coach them in the desired interactions.

If the person is resistant to our training and unwilling to adapt we get rid of them. It is as simple as that. We take a long time hiring the right person for a job, but if they are not a match for us and don’t want to be part of our team we get rid of them quickly. This prevents someone from muddying our culture and it signals to our employees that we are serious about maintaining a great work environment.

We have never understood all of the angst about Millennials in the workplace. In our minds they are young people who are trying to figure out their expanding world. I was no different when I was in my twenties. I am sure older people thought I was lazy and self-absorbed, just like older people did to them decades ago. We don’t label and differentiate Millennials, rather we consider them from the perspective of their stage in life. We do the same for employees who are middle aged. We all want different things at different times in our lives and as employers we need to realize this and create an accommodating workplace where shared values and purpose predominate.

You can click here to visit the Veterinary Business Matters website 

Eight questions and four fallacies about business growth

From an article by Jim Blasinghame published in the Small Business Advocate website

Giant sequoia redwood trees grow very tall. Bradford pear trees, not so much. It's all in the genes.

But there’s no genetic code for a business.

While a Bradford pear can’t decide to compete with a redwood, a business can become whatever its owner makes it. And that last fact creates two questions we go to sleep asking ourselves and wake up trying to answer:

  • 1. Should I grow my business?
  • 2. How big should I grow my business?

In his book, Warp Speed Growth, my friend and Brain Trust member, Peter Meyer, lists four fallacies of growth which every business owner should consider. Here they are, each followed by my comments.

Fallacy 1. You can grow out of organizational problems

In a state of denial or ignorance, small business owners sometimes think getting bigger will fix management and organizational shortcomings. If a tree is bent, fertilizing it won't make it grow straighter – only faster in the wrong direction. If you have organizational challenges, don't grow until they’re resolved.

Fallacy 2. Growth equals profitability.

Yes, increased sales volume can help you improve vendor discounts and therefore, gross margins. But that doesn't mean your organization can manage the extra activity well enough to convert discounts to the bottom line. One of the rudest awakenings an owner can have is when projected sales growth is achieved, but profit is no better, or perhaps worse, than a period of lower sales. Remember Blasingame’s Growth Razor: "It's not what you make, it's what you keep."

Fallacy 3. Profitability improves when every customer is yours.

Being the market leader is overrated. Peter cites research showing only 29% of market leaders were also profit leaders. Not only are you not going to sell every customer, you don't want every customer. Many customers, and some customer profiles, aren’t profitable. Remember, you don't spend sales.

Fallacy 4. If you grow, customers will benefit.

Peter says focusing on growth is focusing on yourself. Every minute your company focuses on itself is a minute diverted away from focusing on the customer. One of the classic examples of a company's self-absorbed focus on growth is when it uses the term "fastest growing" in marketing material, as if this benefited customers. What makes you think customers don't like the size that you are? What makes you think they’ll like your next size?

Don't get me wrong: I'm the last person to say growth is bad, or that you should be happy with the current size of your company. I'm a capitalist, and capitalists LOVE growth. But I do encourage you to make sure that when you grow, it's because you've thought about why and how.

Here are six growth reality checks, each followed by a slap-in-the-face question to ask yourself

  • The marketplace is pretty full already. Is there a real opportunity to grow?
  • Growth requires capital. How will I fund the growth I am planning?
  • The rewards of growth are typically delayed. Can my organization wait that long for the payoff?
  • Growth takes a company into unfamiliar operational territory. Do I have the staff and systems to blaze that trail without creating a casualty list?
  • Being a business owner should be a source of happiness. Will I be happy with a larger business?
  • Every business has corporate values, good or not so much. If our values are good, can we scale them? If they aren’t, why would we scale them?

Ask the growth questions and answer them as Polonius instructed Laetres in Shakespeare’s Hamlet: “This above all, to thine own self be true.

Just because you can grow your business doesn't mean you should.

You can click here to visit the Small Business Advocate website